Epistaxis

Question 1

Little’s Area / Danger area of Face

Answer 1

In anterior inferior part of nasal septum, above vestibule.

Vascular plexus - KIESSELBACH’S PLEXUS (anastomoses)
Anterior ethmoidal A
Sup. Labial A (septal branch)
Sphenopalatine A (septal branch)
Greater palatine A,

Exposed to drying effect of inspiratory current to fingernail trauma.
Usual site for epistaxic in children / young adults.

Question 2

Causes of Epistaxis

Answer 2

Local (Nose / Nasopharynx)
General
Idiopathic

Question 3

Local causes

Answer 3

Nose
Trauma
Infections
Acute
Chronic
Foreign body (living / non-living)
Neoplasm (nose + paranasal sinuses)
Atmospheric changes
Deviated nasal septum

Nasopharynx
Adenoiditis
Juvenile angiofibroma
Malignant tumors

Question 4

General causes

Answer 4

CVS
Htn
Mitral stenosis
Pregnancy
Blood vessels
Bleeding disorders
Liver Diseases
Hepatic corrhosis
Kidney Diseases
Chronic Nephritis
Drugs
Excessive salicylate use
Analgesics
Anticoagulant therapy
Mediastinal Compression (tumors)
Acute General Infection
Influenza
Measles
Chickenpox
Whooping cough
Rheumatic fever
Pneumonia
Typhoid
Dengue
Malaria
Vicarious Menstruation (at time of menstruation)

Question 5

Sites for epistaxis

Answer 5

Little’s are
Above middle turbinate
Below middle turbinate
Post. Part of nasal cavity
Diffuse (septum + lateral wall)
Nasopharynx

Question 6

Classification of epistaxis

Answer 6

Anterior (front of nose )(sitting position)
Posterior (flows back in throat)(swallow)(COFFEE COLOURED vomitus - haematemesis)

Question 7

Management of epistaxis

Answer 7

First aid
Cauterization
Anterior nasal packing
Posterior nasal packing
Endoscopic cauterization
Elevation of mucoperichondrial flap + submucous resection operation
Ligation of vessels
External carotid
Maxillary artery
Ethmoidal arteries